State switching rules
The Medigap birthday rule, state by state
Fifteen states now give Medigap policyholders an annual right to change plans without answering health questions, and no two rules work alike. Here is exactly what each one allows, which states use an anniversary date instead, and where the guarantee does not exist at all.
Figures reviewed for 2026
The basics
An annual right to switch, not a right to buy
Federal rules give you one guaranteed window to buy a Medigap policy: the six months that begin when you are 65 and enrolled in Part B. After that, a carrier in most states can ask about your health, price the policy differently, or decline the application. Congress has never added a federal annual window, so the birthday rule exists only because individual states wrote one.
In a state with a birthday rule, an insurer must accept your application during a set period around your birthday each year, regardless of your medical history, as long as you already have a supplement and you stay within the benefits the state allows. The practical effect is that you are never trapped in a carrier whose rates have run away from the market.
The limit matters as much as the right. A birthday rule does not open Medigap to someone who does not already own it, so it is no help to a person in Medicare Advantage looking for a way back. It also rarely permits an upgrade, because states guarantee lateral moves and let carriers underwrite anything richer.
Three things are true in every state
- You must already be enrolled in a Medigap or Medicare SELECT policy.
- The move cannot add benefits, only match or reduce them.
- The health question disappears; the age-based rate does not.
Where the rules diverge
Four details decide what the rule is worth to you
When the window opens
Windows run from 30 to 63 days. Some begin on the birthday itself, some on the first day of the birth month, and a few start before the date so you can apply early.
Who must accept you
Most states open the whole market to you. Four keep the switch inside your current company or its affiliates, which limits the rule to a rate change rather than a real comparison.
What you can move to
Most states guarantee equal or lesser benefits. A handful guarantee only the identical letter, which means no change of benefits is possible in either direction.
Who qualifies
You must already hold a Medigap policy in every state. A few add age limits, a minimum time in force, or a continuous-coverage test that a lapsed premium can break.
2026 rules
The states with a birthday rule in force
Fifteen states guarantee an annual switch this year, and New Mexico joins them on January 1, 2027. Each card links to the full guide for that state, including what the market looks like and where to check the rule.
California
Long-standing rule- Window
- 60 days beginning on the first day of your birth month
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits, letter for letter or down
Insurers must notify policyholders before the window opens. Because you can move to any company, the California rule is the strongest version of the idea: it turns a Medigap policy into something close to a year-to-year purchase.
Read the California guideDelaware
Effective January 1, 2026- Window
- 30 days before your birthday through 30 days after
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Delaware pairs the new birthday window with two annual guaranteed-issue periods for Medicare Advantage enrollees age 65 and older, October 15 to December 7 and January 1 to March 31. Those Advantage rights allow a carrier to charge more for health and to impose a six-month wait on pre-existing conditions, which the birthday rule does not.
Read the Delaware guideIdaho
Long-standing rule- Window
- 63 days beginning on your birthday
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Sixty-three days is the same length as the federal Medigap trial right, and it is long enough to gather quotes from every carrier writing in the Treasure Valley before you decide.
Read the Idaho guideIllinois
Long-standing rule- Window
- 45 days beginning on your birthday
- Who will take you
- Your current carrier or an affiliate
- What you can move to
- Same letter or a lesser benefit plan
Two limits define Illinois: you must be between 65 and 75 to use the window, and you are shopping within the company you already have, or one of its affiliates. That makes the rule a rate-shopping tool rather than a true market-wide switch.
Read the Illinois guideIndiana
Effective January 1, 2026- Window
- 31 days before your birthday through 31 days after
- Who will take you
- Any carrier
- What you can move to
- The same plan letter only
Indiana allows a lateral move to the identical letter at a different company, so a Plan G holder can leave a carrier that has raised rates twice. It does not permit a change of letter in either direction.
Read the Indiana guideKentucky
Effective January 1, 2024- Window
- 60 days beginning on your birthday
- Who will take you
- Any carrier
- What you can move to
- The same plan letter only
Kentucky replaced underwriting with a plan-for-plan shopping window. Because the benefits cannot change, the only variable is price, which is exactly what the rule is designed to expose.
Read the Kentucky guideLouisiana
Long-standing rule- Window
- 63 days beginning on your birthday
- Who will take you
- Your current carrier or an affiliate
- What you can move to
- Equal or lesser benefits
Louisiana is one of two birthday-rule states that keeps the change inside your own company family. In a market where a handful of carriers write most of the business, confirm which affiliates count before you plan a move.
Read the Louisiana guideMaryland
Effective July 1, 2023- Window
- 30 days beginning on your birthday
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Thirty days is the shortest window on the list, so Maryland policyholders should price the market in the weeks before the birthday rather than after it. The state also adds its own guaranteed-issue events beyond the federal list.
Read the Maryland guideNevada
Long-standing rule- Window
- 60 days beginning on the first day of your birth month
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Because the clock starts at the beginning of the birth month rather than on the birthday itself, Nevadans effectively gain a few extra weeks compared with a birthday-anchored window of the same length.
Read the Nevada guideOklahoma
Long-standing rule- Window
- 60 days beginning on your birthday
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Oklahoma conditions the right on continuous coverage. A gap in your supplement can cost you the guaranteed-issue window even if you meet the age and timing requirements, so pay the premium through the switch rather than after it.
Read the Oklahoma guideOregon
Long-standing rule- Window
- 30 days before your birthday through 30 days after
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Oregon splits the window around the birthday rather than starting on it, which means you can apply before the date. Carriers apply the dates with a little variation, so confirm the exact start with the Division of Financial Regulation.
Read the Oregon guideUtah
Effective 2025- Window
- 30 days before your birthday through 30 days after
- Who will take you
- Your current carrier only
- What you can move to
- Equal or lesser benefits
Utah is the narrowest of the newer rules. You can shed benefits or move to a cheaper version of your letter, but only within the company you already hold, so the value depends entirely on whether that company writes more than one price tier.
Read the Utah guideVirginia
Effective July 1, 2025- Window
- 60 days beginning on your birthday
- Who will take you
- Any carrier licensed in Virginia
- What you can move to
- The same benefits as your current policy
Virginia requires insurers to accept you for an equivalent policy at any company in the state, and the regulator advises keeping your old policy in force until the new one is issued so no gap opens between them.
Read the Virginia guideWest Virginia
Effective June 11, 2026- Window
- 60 days beginning on the first day of your birth month
- Who will take you
- Your current carrier or an affiliate
- What you can move to
- Equal or lesser benefits
West Virginia adds two conditions that no other state imposes: the policy must have been in force for at least 24 months, and the right can be used once every two years. If your carrier does not offer the lesser plan in your county, the state allows a move to another insurer.
Read the West Virginia guideWyoming
Long-standing rule- Window
- 63 days beginning on your birthday
- Who will take you
- Any carrier
- What you can move to
- Equal or lesser benefits
Wyoming has the smallest Medicare population in the country, so the guarantee to switch carriers is only as useful as the number of companies actually writing in your county. Get quotes early and confirm appointments before the window closes.
Read the Wyoming guideA different rule
Missouri protects the policy anniversary, not the birthday
The anniversary rule is not a birthday rule. The date that matters is the month your coverage began, not the month you were born, so two neighbors born in the same week can have windows six months apart. It is also stricter about benefits: Missouri guarantees only an identical plan, so moving from Plan G to Plan N, or from Plan N up to Plan G, generally means answering health questions.
- 1
Cancel your current Medigap or Medicare SELECT policy within 30 days of its annual anniversary date, the date the policy first took effect.
- 2
Apply for the same plan letter with any company offering it in your county. You have 63 days from the cancellation to complete the switch.
- 3
The new insurer must accept you without health questions, because Missouri treats this as a guaranteed-issue event rather than underwriting.
The date that matters
Within 30 days of your policy anniversary, then 63 days to replace it
Who must accept you
Any carrier offering the same plan
What you can move to
The same benefits, which means the same letter
Different mechanisms
States that protect switching another way
A birthday rule is not the only way a state can keep a Medigap market open. These states use a continuous right, an annual window on a different calendar, or a gap test instead.
New York
Continuous guaranteed issue, all yearA supplement cannot be denied for health at any age, and premiums are community rated. The question is never whether you can switch, only which company has the better rate.
Connecticut
Continuous guaranteed issue, all yearInsurers must sell to residents 65 and older without underwriting and without an age curve, so the annual shopping question is purely about price and service.
Massachusetts
Annual guaranteed-issue period plus year-round accessState regulation sets a February 1 to March 31 window, but all insurers in Massachusetts offer year-round open enrollment, and the state uses its own standardized plans rather than the ten federal letters.
Maine
Annual guaranteed-issue month, plus switching after a gapInsurers must offer at least Plan A during a one-month enrollment period the company chooses each year. Policyholders can also switch to a policy with equal or lesser benefits at any time if there has been less than a 90-day gap in coverage.
Washington
Switching allowed any time after a 90-day gap testWashington lets a policyholder move to a policy with equal or lesser benefits at any point in the year as long as coverage has not lapsed for more than 90 days. Plan A holders can only move to Plan A; Plans B through N can move among themselves.
Rhode Island
Annual window during Medicare open enrollmentA 2025 law lets current Medigap policyholders switch to any policy from any insurer during October 15 to December 7. Medicare Advantage enrollees 65 and older also gain an annual guaranteed-issue right to buy a supplement, which people in Original Medicare without a supplement do not have.
Minnesota
One-time guaranteed issue between 65 and 70From August 1, 2026, residents aged 65 to 70 may buy a supplement without health questions during the October 15 to December 7 open enrollment period. Insurers may charge more under this right, and Minnesota uses its own standardized plans.
New Mexico takes effect January 1, 2027. New Mexico enacted a birthday rule in March 2026 that takes effect January 1, 2027. From that date, policyholders will have at least 60 days beginning in their birth month to move to a plan of equal or lesser benefits with any carrier.
If your state has no rule at all
In the remaining states, the federal calendar is the whole story. Your six-month Medigap open enrollment period is the only time a carrier must sell at its best rate, and the federal guaranteed-issue events that follow are narrow: losing employer coverage that paid secondary to Medicare, a carrier leaving the market, and your first year in an Advantage plan. A diagnosis after that window can mean a higher premium for identical coverage, or no policy at all, which is why the decision at 65 is worth more attention than the price of the first year.
Answers
Birthday rule questions
Can I use the birthday rule to leave Medicare Advantage and buy a supplement?
No. Every birthday rule applies only to people who already own a Medigap policy, so it does nothing for someone enrolled in Medicare Advantage. Leaving Advantage for a supplement still depends on federal trial rights, which last 12 months, or on passing medical underwriting.
Does the rule let me move up to a richer plan?
Almost never. States guarantee a move to equal or lesser benefits, and a few guarantee only the same letter. Going from Plan N up to Plan G, or from Plan G to Plan F, is treated as a new application and can be underwritten, declined, or rated higher.
What happens if I miss the window in my state?
You wait for the next year. Outside the window, an insurer in a birthday-rule state may still ask health questions, and the answer is not guaranteed. A missed window costs twelve months, not the right itself.
Should I cancel my old policy before the new one is approved?
No, except where a state requires it. Keep the old policy in force until the new one is issued and its effective date is confirmed, because a coverage gap can disqualify you and because a deductible you have already met does not carry over.
Are the rates the same after a birthday-rule switch?
No. The new carrier prices you at its own filed rate for your age, tobacco use, and in some states your ZIP code. The rule removes the health question, not the underwriting of age, so the point of switching is finding a cheaper filed rate for identical benefits.
Official sources
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Every figure on this page comes from the agencies below. They are the primary record, and none of these links costs you anything.
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